Cerebral autoregulation–guided blood pressure management to reduce delirium in adults: a meta-analysis of randomised controlled trials

Delirium is an acute and fluctuating disturbance of consciousness, attention, and cognition, which frequently occurs in adult surgical and ICU populations. Its importance is increasingly recognised due to its association with prolonged mechanical ventilation and extended length of hospital stay. Furthermore, it is linked to long-term cognitive decline and higher mortality. Despite these serious consequences, few intraoperative or resuscitation strategies have been shown to reduce its occurrence. Cerebral autoregulation-guided blood pressure management has emerged as a potential personalised approach to maintain adequate cerebral perfusion. However, individual randomised controlled trials have been underpowered to draw definitive conclusions regarding its delirium-preventive effects.